ADDICTION TREATMENT CENTER

What Are the Stages of Alcoholism?

By:
theohanahawaii
September 16, 2022

About 14.5 million people struggled with alcohol use disorder (AUD), according to a 2019 national survey. Despite being a common struggle, many people find it difficult to seek help. 

What Is Alcoholism? 

Alcoholism is a general term used to describe AUD. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), AUD is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. 

As a brain disorder, AUD causes physical harm to your brain while impairing mental functioning. 

This disorder can differ for each individual. Some cases are less severe while others develop co-occurring disorders. 

Many factors can lead to the onset of AUD. Regardless of the cause, evidence-based treatment and behavioral therapies can effectively be used to treat AUD. However, to get to the root cause, it is essential to understand the potential risks of AUD occurring.

What Causes Alcohol Use Disorder? 

According to the American Psychological Association (APA), AUD often develops in reaction to multiple factors: 

  • Genetics plays a significant role in the development of AUD. Having family members with AUD increases the risk of a person developing it. This does not necessarily mean that everyone with a family history of AUD struggles with the disorder, but it does increase the potential risk. 

  • Environmental factors are also significant. For instance, being in a home where excessive alcohol use is present increases the chances of AUD developing later in life.

  • Traumatic events can lead people to use alcohol as a coping mechanism, often leading to AUD.  

  • Social factors like culture and peer pressure can play a role in the likelihood of drinking and developing a problem with alcohol use. 

These are simply a few of the factors that commonly lead to the development of AUD. What's crucial is determining if you can recognize the signs of AUD within your loved ones or yourself.

Recognizing the Signs

Regarding the signs and symptoms of alcoholism, there are physical, mental, and behavioral signals to look out for. Some of the most common symptoms include: 

  • Lack of coordination

  • Slurred speech

  • Impaired thought processes

  • Memory impairment

  • Inability to stop use

  • Diverting energy from work, family, and social life to drink

  • Being secretive about the extent of the alcohol use

  • Engaging in risky behavior, such as drunk driving

  • Being in denial about the extent of the alcohol being consumed

  • Becoming distressed when alcohol is not available

The ability to recognize the signs can mean all the difference between saving your own life or the life of a loved one. 

Determining the Severity of Your Illness

The symptoms associated with AUD are recognizable. When seeking professional help, healthcare professionals reference the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), these professionals will ask if you have engaged in the following behaviors within in the past year: 

  1. Had times when you drank more or longer than you intended?

  2. More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

  3. Spent a lot of time drinking? Or being sick or getting over other aftereffects?

  4. Wanted a drink so badly you could not think of anything else?

  5. Found that drinking — or being sick from drinking — often interfered with taking care of your home or family, caused job troubles, or troubles with school?

  6. Kept drinking even though it was causing trouble with your family or friends?

  7. Given up or cut back on activities that were important, interesting, or pleasurable to drink?

  8. More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unprotected sex)?

  9. Continued drinking even though it made you feel depressed or anxious, or contributed to another health problem? Or after having had a memory blackout?

  10. Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

  11. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

Questions such as these help mental health professionals determine the severity of your illness and what actions to take next in terms of seeking treatment or other professional help. These 11 symptoms will also determine which stage of alcoholism you are experiencing. 

Treatment Methods

The most effective addiction treatment methods are those tailored to individual needs. There are, however, several options when seeking treatment for AUD. For many, a combination of medication and behavioral therapies is the most effective.

People often experience withdrawal symptoms during the earliest stages of treatment. Medications can help ease these symptoms and increase the continuation of treatment success. People struggling with AUD should consult their health care provider if they have any concerns about using medications during the treatment and to find the medications that best fit their situation. 

Behavioral Therapies 

Just as there is a wide range of medications used in treating AUD, there is also a wide range of behavioral therapies

  • Cognitive-behavioral therapy (CBT) helps clients identify the feelings and situations that lead to drinking and teaches coping techniques to prevent drinking, learning how to interrupt negative thought patterns

  • Motivational enhancement therapy helps clients strengthen their desire to alter their behavior. It focuses on identifying the pros and cons of treatment, creating a plan, building confidence, and learning healthy skills to maintain your plan to quit drinking.

  • Dialectical behavior therapy (DBT) helps clients regulate their emotions, develop skills and boundaries within interpersonal relationships, and learn how to tolerate distressing situations. 

These are just a few behavioral therapies that effectively treat AUD and several other mental disorders. The treatment you seek may depend on the stage of alcoholism. 

4 Stages of Alcoholism 

There are four stages of alcoholism. Individuals struggling with AUD may not even realize they have a problem, let alone understand their current stage. The stages of alcoholism include early, problematic, severe, and end-stage.

#1. Early Alcohol Use

The early stage of alcoholism is commonly viewed as an introduction to alcohol. Most people are introduced to alcohol at a young age. High school students and young adults typically begin experimenting with alcohol use and are unaware of the dangers that can arise.

This stage is also a time when binge drinking develops. In social situations, people easily exceed a moderate level of consumption. The experimental phase of the early stage is where things end, but for those with a history of AUD in the family or who have co-occurring mental disorders, experimentation may turn into an addiction.

#2. Problematic Alcohol Use 

This stage of alcoholism is when people start losing control over their alcohol consumption. Individuals will typically exhibit about three of the symptoms listed previously. Alcohol begins affecting parts of their life, and they start exhibiting more AUD symptoms. 

What separates problematic alcohol use from a more severe state is that AUD has not fully developed. Individuals may be more dependent on alcohol than they should be, but symptoms are more manageable, and seeking treatment can help before it wreaks more havoc.

#3. Severe Alcohol Use 

Experiencing six or more of the 11 symptoms listed previously indicates the need for a treatment intervention. This signifies a severe stage of alcoholism. Symptoms worsen during this stage, and an individual's overall health and well-being will begin to decline simultaneously. 

Aside from the dangerous behavior associated with AUD, another significant concern are the health conditions that can develop as a result. Severe, chronic alcohol use can lead to: 

  • Cardiovascular disease 

  • Anemia 

  • Dementia 

  • Cirrhosis 

  • Cancer 

  • Seizures

  • Co-occurring mental disorders such as anxiety and depression 

  • High blood pressure 

  • Nerve damage 

  • Pancreatitis 

  • Other infectious diseases 

If untreated, these conditions can be severe and potentially lead to death. 

#4. End-Stage Alcohol Use

End-stage alcohol use is when someone is beyond the point of quitting on their own. If they attempt to quit, withdrawal symptoms become painful and even dangerous. In a way, someone in the end stage has stopped living in order to drink – and is now drinking to live. 

Liver failure is extremely common among people in the end stage of alcohol use. Continually consuming alcohol causes the liver to produce scar tissue, ultimately preventing blood flow to the liver. The body can not cleanse itself of toxins, handle infections, or absorb nutrients needed to survive. 

Liver failure is not the only harm of end-stage alcoholism. You could also be susceptible to malnutrition, pancreatitis, cardiovascular diseases, and many cancers such as mouth, esophagus, liver, colon, breast, and skin. 

Individuals in this stage are at an increased risk of developing alcohol dementia, a type of alcohol-related brain damage. Symptoms of alcohol-related dementia include:

  • Struggle with daily tasks 

  • Memory loss

  • Difficulty focusing and problem-solving

  • Lack of balance

  • Mood changes

Treating Alcohol Dementia 

There are different ways to treat alcohol dementia. Firstly, individuals must stop drinking. 

Due to the dangers of withdrawal, individuals should remain in a hospital setting as medications to help with withdrawal symptoms are administered in a safe environment. 

Similarly to treating alcohol and substance use disorders, behavioral and psychotherapies are often used to treat alcohol dementia. The length of treatment will vary from person to person. 

(For help, reach out to your medical provider. They can refer you to a mental health professional.)

Recovering From AUD 

Recovery is an individual journey. 

Individuals seeking freedom from active addiction need to have a place to turn, including treatment programs and recovery resources. Finding out which programs and resources are right for you will require research. 

Depending on your situation, you may need a virtual program. Others may need a more intensive outpatient program or partial hospitalization program. Discussing options with your doctor will help you sift through the possibilities and choose what works best for you. 

Treatment will be difficult at first, but every obstacle you overcome is worth celebrating. 

During treatment, you will have the chance to experiment with different talk therapies, learn holistic coping methods to handle triggers or cravings, and widen your support network. 

AUD is an isolating disorder, but you do not need to overcome it on your own. Hundreds of people struggle with alcoholism every day and by making connections during treatment, you'll feel a little less alone as you build your support system.

Create a Recovery Plan

You will also create a recovery plan during treatment. 

This plan will help you integrate back into everyday life post-treatment and increase your chance of long-term recovery maintenance. The first step to a life of recovery must be taken by you. 

A person's struggle with AUD affects more areas of their lives than they ever realize. In a TEDx Talk about alcoholism and the deadly truth regarding the stigma associated with it, speaker Sarah Drage discusses why she believes such a stigma killed her father who struggled with excessive alcohol use. Check out the powerful video here

Whatever stage of alcoholism you find yourself or a loved one in, consider seeking treatment today.

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